Picture this. Swish London restaurant. Penguin-suited maitre-d’ ushers you in to the kitchen where you present the finest of ingredients, all handpicked by you that afternoon from the best London markets. The faux-fracais accented chef inspects your produce closely, then gives the thumbs up: c’est magnifique!
(we-ell, he has to keep in character somehow).
Then he points you to the stove and insists that you get on and prepare your own meal. Gold standard? No way. Not even close.
The NHS Gold Standard
Yet that, according to some senior bigwig from the NHS, chatting to C4 news tonight, is precisely what will be offered to the thousands of women now terrified of the health risks posed by their PIP breast implants. France will pay for them to be removed. Germany will pay for them to be removed.
Back in good old Blighty, though, all that’s on offer is a check-up with a skilled clinician courtesy of the NHS, and their replacement on the state if the NHS put them in in the first place. Otherwise, its up to you. You need to sort out the private facility for removal. You need to pay for their replacement. You need to suffer the fear – and take the risk.
But this, according to our sharp-suite NHS bigwig, in contrast with the scuzzy diner offering from our continental neighbours, is the UK doing “gold standard”. Yeah, yeah: we’ve seen it all before.
The British way
In fact, it’s a very British way of doing things. Ignore and ignore and ignore and resist all claims until the last possible moment: cause the maximum upset amongst your customers (or patients, if you prefer).
Only when it becomes impossible to do anything else will you give in to the inevitable and pay for the work that you could probably have done up front in the first place without the grief, without all the costly legal bills – and without the collateral damage that may result from delay.
Sure: I can hear them now…the whingers over at the Taxpayers’ Alliance…and the guys around the bar of their local. These were COSMETIC procedures, for F’s sake. People opted for these operations as lifestyle choices and if they go wrong, tough.
Except that attitude itself is born of the most awful, misogynistic sexism: and the suggestion that it would be cheaper not to help out is just stupid.
The sexism comes with the unspoken “just” that always precedes the c-word. We live in a world in which women, from cradle to grave are made to feel bad about themselves according to how they look. Some avoid this burden, some feel it lightly – while for others it can become an intolerable psychological challenge.
The NHS recognises this already, in that many pct’s will pay for breast ops where there is either significant lopsideness or some other feature that causes constant embarrassment. In that sense, therefore, it certainly feels as though the NHS is suddenly beating a very swift retreat from established practice.
The cost of saving money
The stupidity lies in the knock-on damage likely to be done by this penny-pinching policy. Many of the enterprises that put these implants in, first time round, are no longer there. So any replacement will need to be paid for by the individual concerned. Who may or may not be able to afford the work, depending on how hard they had to save to begin with.
There will be fear and depression which will, in some instances, be enough to knock productive members of the workforce out of work. Cost! There will be botched removals, followed by individuals who now DO meet the pct subsidy criteria. Cost! There will be legal challenge. Cost! Worst of all will be the many implants going bad and requiring emergency surgery. Yet more cost!
At the end of the day, its not a choice between the government spending £150 million – which is, besides, no more than one of those Daily Mail conjured figures – and not spending anything. It’s a choice between spending whatever the real cost is… and the perhaps equally costly option of trying to get away with doing the minimum.
The real saving is likely to be far less. But the difference can be measured in trauma for the women involved.
Not even a gold-plated standard!